Provider Demographics
NPI:1386415727
Name:SOUND MIND THERAPEUTIC CENTER, LLC
Entity type:Organization
Organization Name:SOUND MIND THERAPEUTIC CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEFFICH
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:304-641-3891
Mailing Address - Street 1:41 DEVONWOOD DR APT 101
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:WV
Mailing Address - Zip Code:26330-8026
Mailing Address - Country:US
Mailing Address - Phone:304-641-3891
Mailing Address - Fax:
Practice Address - Street 1:41 DEVONWOOD DR APT 101
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:WV
Practice Address - Zip Code:26330-8026
Practice Address - Country:US
Practice Address - Phone:304-641-3891
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty